| NPI | 1043422207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: WI 52241) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: AZ 46060) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2023-04-26 |