| NPI | 1386656213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: MI 4301077751) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: TX Q4421) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2020-10-21 |