| NPI | 1588656698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME149374) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 203277) |
| 207Y00000X Otolaryngology (Licence: IN 01088921A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 203277) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01088921A) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2023-11-20 |