| NPI | 1831327634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 51319) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301094276) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2018-02-21 |