| NPI | 1477765071 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01070924A)  | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01070924A)  | 
| Enumeration Date | 2007-05-04 | 
| Last Update Date | 2020-09-15 |