| NPI | 1194430975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: AZ 72536) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: MA 2085R001X) |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2024-09-19 |