| NPI | 1891923918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 52912) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 21339) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 52912) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MS 21339) | |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2021-12-01 |