| NPI | 1740448240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01068253A) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: KY 47078) |
| 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.123448) | |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2022-12-09 |