| NPI | 1558534602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: HI MD15308) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: CA A95084) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2009-11-20 |