| NPI | 1992719181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 17901) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-4205) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN MD0000039143) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1017917) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-11-09 |