| NPI | 1588710487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD-9398) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G75490) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME75328) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2022-11-16 |