| NPI | 1285967141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX R5241) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2018004388) |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2023-07-12 |