| NPI | 1366472102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 27996) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX 45760) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2022-08-31 |