| NPI | 1992775530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 7771) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 24406) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2023-01-12 |