| NPI | 1669856332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 17957) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01084510A) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01084510A) | |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2022-07-19 |