| NPI | 1669639605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 45959) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 11013730A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01070895A) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2020-02-14 |