| NPI | 1558525535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NC 2024-02352) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01061170A) |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2024-09-30 |