| NPI | 1558705210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01080855A) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: KY 55050) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2021-07-20 |