| NPI | 1245339282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 9600045) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2012030860) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2022-08-29 |