| NPI | 1457307993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CA C129444) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01054923A) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MA 239999) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2019-06-13 |