| NPI | 1588828909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01078935) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.132065) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 35.132065) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01078935) | |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2018-04-23 |