| NPI | 1316262363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD466047) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101280527) |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2024-02-29 |