| NPI | 1699757799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01053091A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 39051) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2022-03-25 |