| NPI | 1295932242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX N3228) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: TX BP10022820) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2021-12-09 |