| NPI | 1033117452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA G71213) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OR MD190314) |
| Enumeration Date | 2005-07-09 |
| Last Update Date | 2023-09-18 |