| NPI | 1255379996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301048588) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01037783) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2018-12-06 |