| NPI | 1447234141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 23861) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 032885) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2021-03-02 |