| NPI | 1588155212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01084023A) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NM MD2024-1091) |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2025-08-06 |