| NPI | 1730211046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD28295) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301091672) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01063088a) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2025-03-05 |