| NPI | 1962829804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 75656) |
| Additional Taxonomies | 2085N0700X (Licence: UT 11250302-1205) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01085728a) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 11250302-1205) | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2025-03-19 |