| NPI | 1710128756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 23849) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD13246) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 12691) | |
| Enumeration Date | 2009-03-22 |
| Last Update Date | 2023-09-08 |