| NPI | 1487698973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: TX T9128) |
| Additional Taxonomies | 2085N0700X (Licence: IN 01060899) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01060899) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX T9128) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2025-11-12 |