| NPI | 1043743883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OR MD202827) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CO DR.0072211) |
| Enumeration Date | 2017-04-08 |
| Last Update Date | 2023-12-04 |