| NPI | 1659798643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0064326) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: CO DR.0064326) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 19780) | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2024-10-31 |