| NPI | 1235194952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AZ 46064) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OK 26969) |
| 2085R0001X Radiology, Radiation Oncology (Licence: FL ME92074) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2020-09-03 |