| NPI | 1841498821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q6029) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301078342) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01066217A) | |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2022-10-18 |