| NPI | 1386811263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01069990A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M9583) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.097940) | |
| Enumeration Date | 2008-05-10 |
| Last Update Date | 2011-10-12 |