| NPI | 1023520095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: HI MD-21939) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: CA C185646) |
| 2085R0001X Radiology Radiation Oncology (Licence: NY 289911-1) | |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2023-05-22 |