| NPI | 1306930342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA C54737) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX K8726) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-11-27 |