| NPI | 1689885188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01067062) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 232086) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2021-02-24 |