| NPI | 1831168426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01050561A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 14172C) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2026-05-20 |