| NPI | 1457409930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01058177A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01058177A) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-03-13 |