| NPI | 1215319751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 11018610A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2015017146) |
| Enumeration Date | 2015-06-21 |
| Last Update Date | 2016-06-20 |