| NPI | 1487018768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 64986) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MS 25741) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-13553) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 64986) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 25741) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AR E-13553) | |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2024-09-03 |