| NPI | 1700203775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 20088) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 11181115-1205) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2023-09-08 |