| NPI | 1295912889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN MD00000045823) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 31121) |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2023-01-31 |