| NPI | 1801056833 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101251332)  | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01066433A)  | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 11013608A)  | |
| Enumeration Date | 2008-06-12 | 
| Last Update Date | 2012-07-20 |