| NPI | 1336235456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OK 30459) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A51355) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2021-10-12 |