| NPI | 1467442939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX D6938) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01091245A) |
| 208D00000X General Practice (Licence: OK 27491) | |
| 208D00000X General Practice (Licence: TX D6938) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2023-10-09 |