| NPI | 1639465032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 17377) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO CDR.0004464) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2025-03-25 |