| NPI | 1609138395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01083620A) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS44029) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11018469A) | |
| Enumeration Date | 2012-06-09 |
| Last Update Date | 2022-11-23 |