| NPI | 1558362996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01050281A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 25910) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01050281A) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: KY 25910) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2023-08-01 |