| NPI | 1174611511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AR E-0729) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: ND 8183) |
| 2085R0001X Radiology, Radiation Oncology (Licence: MS 27989) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: TN 57553) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: MO 111463) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2021-06-22 |