| NPI | 1700825148 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01059903) | 
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: IN 01059903) | 
| Enumeration Date | 2006-06-04 | 
| Last Update Date | 2010-02-26 |