| NPI | 1982712162 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01066255A) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD19106) | 
| Enumeration Date | 2006-08-28 | 
| Last Update Date | 2020-06-04 |