| NPI | 1851374003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01039491A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 34038) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2016-03-24 |