| NPI | 1265759690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01077171A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 49366) |
| Enumeration Date | 2010-04-25 |
| Last Update Date | 2016-06-27 |