| NPI | 1417998717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD-10078) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 4083A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 27092) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: NE 21261) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2019-07-10 |