| NPI | 1417937418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD14398) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY TP521) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 056313) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2024-08-26 |