| NPI | 1831232479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 08741) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR R3603) |
| 174400000X Specialist (Licence: AL 00011578) | |
| 174400000X Specialist (Licence: TX H1781) | |
| 174400000X Specialist (Licence: MS 08741) | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2023-03-07 |