| NPI | 1912168915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01072622A) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 57014227) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2021-02-04 |