| NPI | 1922207059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 43586) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 13394C) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 33293) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO CDRH.0063132) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2021-04-05 |