| NPI | 1093775694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IN 02005479A) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: KY 04403) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2019-09-30 |