| NPI | 1285722892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301507980) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL TRN6794) |
| 2085R0001X Radiology, Radiation Oncology (Licence: CA A101205) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2022-12-21 |