| NPI | 1003027582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: SD 7563) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: ND 10766) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2023-12-26 |