| NPI | 1285896936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX N3627) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: GA 069799) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2019-12-27 |