| NPI | 1265522593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: SC 27213) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2009-00567) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2022-03-08 |