| NPI | 1073932877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A140640) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: LA 307422) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2022-09-19 |