| NPI | 1992144976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD22415) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 143274) |
| Enumeration Date | 2013-06-23 |
| Last Update Date | 2019-01-24 |