| NPI | 1821301946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: WI 67497) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MI 4301097006) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01075295A) | |
| Enumeration Date | 2010-07-18 |
| Last Update Date | 2022-07-21 |