| NPI | 1285798066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 64920) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 16354) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2023-12-14 |