| NPI | 1760593099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: HI MD-13598) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WA ML20008239) |
| 2085R0001X Radiology, Radiation Oncology (Licence: CO DR.0054195) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-01-11 |