| NPI | 1902086549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 20424) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL MD.32458) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 46637) | |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2026-04-08 |