| NPI | 1407844715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MS 26077) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2003027615) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2022-04-29 |