| NPI | 1962829804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01085728A) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: UT 11250302-1205) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: UT 11250302-1205) | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2021-08-10 |