| NPI | 1356308209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: LA MD.025321) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 025321) |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: LA MD.025321) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2023-09-20 |