| NPI | 1407874167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NH 22087) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OR MD26549) |
| 2085R0001X Radiology, Radiation Oncology (Licence: VT 042.0015551) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: WA MD00028703) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-11-04 |