| NPI | 1316246572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 02005987A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 62140) |
| Enumeration Date | 2011-03-26 |
| Last Update Date | 2020-07-28 |