| NPI | 1306020474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NH 34147) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CT 047350) |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2025-02-07 |