| NPI | 1477523710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD-11086) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR 24283) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2011-08-02 |