| NPI | 1396834412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OR MD186291) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CO 49432) |
| 2085R0001X Radiology, Radiation Oncology (Licence: NM MD2023-0362) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2023-12-27 |