| NPI | 1447512868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-11126) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2017006926) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2023-09-20 |