| NPI | 1043293764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AZ 21559) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME70063) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2020-09-08 |