| NPI | 1346322567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A111479) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WA ML20008759) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2020-02-20 |