| NPI | 1295842045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: SC 33702) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2006-00638) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2021-01-06 |