| NPI | 1841586286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0062732) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 5101019146) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 2999) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2019-10-03 |