| NPI | 1427118686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME114673) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR C7538) |
| 2085R0001X Radiology, Radiation Oncology (Licence: WA MD00034758) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-05-29 |