| NPI | 1861654550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 71207) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01068913A) |
| 208D00000X General Practice (Licence: IN 01068913A) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2024-02-02 |