| NPI | 1952612046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NH 22333) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 244911) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 22333) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2022-04-21 |