| NPI | 1376003442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101282553) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 43829) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01093859A) | |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2024-07-12 |