| NPI | 1699715847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: HI DOS1114) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 20A7763) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2023-06-09 |