| NPI | 1376898411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD61417205) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: AL 35914) |
| Enumeration Date | 2012-07-15 |
| Last Update Date | 2023-06-29 |