| NPI | 1548528029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01080201A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GU EMTL-2022-030) |
| 2085N0700X (Licence: IL 125069773) | |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2022-10-31 |