| NPI | 1134392152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX FG1865851) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NC 134708) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2021-05-24 |