| NPI | 1043211360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101052359) |
| Additional Taxonomies | 174400000X Specialist (Licence: DC MD31361) |
| 2085R0001X Radiology, Radiation Oncology (Licence: MD D65128) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2022-10-26 |