| NPI | 1104879964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AR N-7796) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: AR N7796) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2016-06-06 |