| NPI | 1932129756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01051207A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01051207A) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2015-05-14 |