| NPI | 1972605897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01071272A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 55517) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.099453) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 45329) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2015-01-19 |