| NPI | 1598728891 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD-16297) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M9222) | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VT 042-0010901) | |
| Enumeration Date | 2006-04-08 | 
| Last Update Date | 2015-06-23 |