| NPI | 1326213919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 47200) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 22264) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2017-05-03 |