| NPI | 1609366939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 74339) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AL md.48761) |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2025-06-25 |