| NPI | 1558326629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C170088) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD11796) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2022-11-16 |