| NPI | 1407083058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AR E11178) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OK 27299) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2023-08-18 |