| NPI | 1952377418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 116018805) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01056685A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2010-00619) | |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2011-07-15 |