| NPI | 1336468636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NE 30395) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TN MD53147) |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2024-03-16 |