| NPI | 1770924656 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01080427A) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11017982A) | 
| Enumeration Date | 2013-07-08 | 
| Last Update Date | 2020-08-19 |