| NPI | 1598956641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TN 49009) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MS 22171) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2023-05-18 |