| NPI | 1376594507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 37386) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0053989) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01042301) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2021-07-12 |