| NPI | 1114969144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MO 101788) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY 251157) |
| 2085R0001X Radiology, Radiation Oncology (Licence: OK 21117) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2025-02-20 |