| NPI | 1093760191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology Therapeutic Radiology (Licence: TX H4653) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: TX H4653) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2022-02-25 |