| NPI | 1013043009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: LA 339029) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: ND 20165) |
| 2085R0001X Radiology, Radiation Oncology (Licence: MS 13362) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: AL 19443) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2024-03-07 |