| NPI | 1184986879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: GU M-2364) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: CA A129865) |
| Enumeration Date | 2012-06-09 |
| Last Update Date | 2023-03-13 |