| NPI | 1558566992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX M5926) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01065020A) |
| Enumeration Date | 2007-06-17 |
| Last Update Date | 2010-07-30 |