| NPI | 1568494631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 20801) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 13060) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR R4317) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2022-12-06 |