| NPI | 1689735805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX S4703) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IN 02003005A) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-06-02 |