| NPI | 1235452723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 53113) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 53113) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 24088) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MS 24088) | |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2019-04-04 |