| NPI | 1861663387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NH 18309) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NH RT2162) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: VT 042.0013683) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NH LT-3862) | |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2017-09-13 |