| NPI | 1881779700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 47571-020) |
| Additional Taxonomies | 2085N0904X (Licence: IN 01065200A) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2013-05-16 |