| NPI | 1043407414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD60459328) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2012-00961) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2021-03-31 |