| NPI | 1568648889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 59599) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01064707A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 81414) | |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2025-05-30 |