| NPI | 1558342741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: IN 01076005A) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: NY 235396-1) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2025-04-02 |