| NPI | 1114912383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 1030485) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01030485A) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01030485A) | |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2015-05-06 |