| NPI | 1871797365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 71102) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N6506) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2024-06-14 |