| NPI | 1285844183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2008-00671) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: AL 26535) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2024-04-18 |