| NPI | 1306231923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MD D0093046) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2021034081) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2022-03-30 |