| NPI | 1992065445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 56686) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-10117) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 22996) | |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2022-03-03 |