| NPI | 1437153095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 35362-021) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 02004140A) |
| 208D00000X General Practice (Licence: IN 02004140A) | |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2015-09-27 |