| NPI | 1265894190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX 297704) |
| Additional Taxonomies | 281P00000X Chronic Disease Hospital |
| Enumeration Date | 2016-03-21 |
| Last Update Date | 2023-10-02 |