| NPI | 1194103317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01083723A) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.149466) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2025-02-03 |