| NPI | 1194747733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD00045874) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OR MD26337) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2022-02-04 |