| NPI | 1770554495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 20392) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01054679A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 1770554495) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2020-09-01 |