| NPI | 1942643150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AR E-12138) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: TX R6193) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2019-10-30 |