| NPI | 1386681773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01055190A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 190452) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2021-03-23 |