| NPI | 1982781373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 66540) |
| Additional Taxonomies | 2085N0700X (Licence: IN 01058893) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01058893) | |
| 2085N0700X (Licence: WI 66540) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2017-01-17 |