| NPI | 1669816807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01080620A) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX 573273) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2018-08-20 |