| NPI | 1649306390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: CO 49846) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD17493) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 54301) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-34934) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 26147) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA L-227552) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2024-03-31 |