| NPI | 1235103425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AZ 64298) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME80426) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2021-11-05 |