| NPI | 1528390200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01084508A) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX R2886) |
| 208D00000X General Practice (Licence: NY 272711-1) | |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2022-01-25 |