| NPI | 1295763969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WV 29214) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MI JL407316) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2019-08-26 |