| NPI | 1689897563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 42547) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 19878) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2016-05-26 |