| NPI | 1477549293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: KY 24674) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01037798) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2020-12-04 |