| NPI | 1487683991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TN 44204) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MS 18738) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2022-07-21 |