| NPI | 1942209747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR N-6521) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 054388) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2018-03-17 |