| NPI | 1417342999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: KY 50822) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: KY R3732) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2024-06-03 |