| NPI | 1649260910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 324752) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01056857A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 6496044-1205) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2022-12-09 |