| NPI | 1760820625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 58955) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 58955) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AR E-12225) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MS 26602) | |
| 208600000X Surgery (Licence: IL 125-062891) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2023-03-02 |