| NPI | 1548245772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301508350) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01064288A) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2023-10-25 |