| NPI | 1407170467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AK 101033) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD60973030) |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2023-07-21 |