| NPI | 1518954759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 57395) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR R3815) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2018-05-31 |