| NPI | 1306831862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NM MD2007-0122) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01055416) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2023-07-17 |