| NPI | 1417154436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: CA A109259) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: PA MT187129) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2024-01-17 |