| NPI | 1417249418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: LA 311217) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: AL MD.35172) |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2019-01-03 |