| NPI | 1134513054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX S5194) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NM MD2020-0247) |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2022-07-18 |