| NPI | 1528385341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01076582A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: KY R2580) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY R2580) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01076582A) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 11018095A) | |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2024-05-01 |