| NPI | 1740254382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01052919A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 49391) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2021-07-13 |