| NPI | 1639515059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AR E-12149) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TN 52183) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2021-01-13 |