| NPI | 1679759898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: IN 01083272A) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MS 21048) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: GA 001400) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MS 21048) | |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2022-11-01 |