| NPI | 1720006489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 18366) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 34020) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI EMC0006350) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2025-01-08 |