| NPI | 1033402995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OR MD184729) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WA 60610300) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2022-07-21 |