| NPI | 1326087487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD20349) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME78473) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VT FF0532689) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2019-10-18 |