| NPI | 1245359728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2008-00734) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: SC 30724) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2023-03-21 |