| NPI | 1881125243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01087593A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 11019917A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 1593509) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2022-06-03 |