| NPI | 1710208087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 60622) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 21863) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2021-03-02 |