| NPI | 1194037721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01077071A) |
| Additional Taxonomies | 2085N0700X (Licence: WI 63175-20) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301097150) | |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2020-12-29 |