| NPI | 1326213919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 47200) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: TN 47200) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 49592) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 22264) | |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2025-02-06 |