| NPI | 1316263353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2022-01120) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: GA 63868) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2022-10-03 |