| NPI | 1013901545 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01046756A) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 1046756) | 
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01046756A) | |
| Enumeration Date | 2005-09-12 | 
| Last Update Date | 2021-01-13 |