| NPI | 1730447848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH RT-2441) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VT 042.0013881) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 18354) | |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2019-02-15 |