| NPI | 1184770992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01062509A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME159272) |
| 208D00000X General Practice (Licence: IN 01062509A) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2024-06-04 |