| NPI | 1508066911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 20301) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS T-1819) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD.204469) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2023-01-17 |