| NPI | 1275910960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: ID O-1379) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: WA OP61043781) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2023-08-25 |