| NPI | 1477765071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME150247) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01070924A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01070924A) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2025-12-26 |