| NPI | 1366769069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TN 53038) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA BP1-0036590) |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2020-10-27 |