| NPI | 1700901212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD15853) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A84927) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A84927) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2011-01-18 |