| NPI | 1164422697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: TN 63572) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: IN 01048136A) |
| 2085R0001X Radiology Radiation Oncology (Licence: GA 072738) | |
| 2085R0001X Radiology Radiation Oncology (Licence: FL ME63028) | |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2021-08-19 |