| NPI | 1669450086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TX P3891) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: OK 23946) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01053879A) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2015-08-04 |