| NPI | 1245432079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 40843) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01076129A) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2017-01-05 |