| NPI | 1396765335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: ID M13009) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: HI MD 13873) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2016-04-11 |