| NPI | 1730171661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NV 14711) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01045419) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2018-03-15 |