| NPI | 1932361250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NC 2022-02058) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01063226A) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2022-11-07 |