| NPI | 1770577538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01041539A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 1041539) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01041539A) | |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2021-01-13 |