| NPI | 1265479760 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WI 29163) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CO DR.0056171) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2025-02-17 |