| NPI | 1265742696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01077564A) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MO 2015013917) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2024-03-14 |