| NPI | 1730447186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-13992) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 8809928-1205) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2018-05-14 |