| NPI | 1306330980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 02005796A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R11262) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA R11262) | |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2023-09-15 |