| NPI | 1750336590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2011-01533) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01061773) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2021-03-29 |