| NPI | 1265636575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01067700A) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A99981) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2020-06-15 |