| NPI | 1497781900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M3798) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD18030) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2022-10-25 |