| NPI | 1992325781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 6807) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R3324) |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2026-07-08 |