| NPI | 1487607990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: NH 12847) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 12847) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 37037) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2018-08-27 |