| NPI | 1174679799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CO DR.0056012) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX N5953) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-06-17 |