| NPI | 1396006599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MD D83095) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CT 059961) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2021-03-08 |