| NPI | 1801871876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MN 38919) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01052032A) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2023-03-29 |