| NPI | 1619455987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IN 11022059A) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL 26277) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2022-07-18 |