| NPI | 1437215886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OK 28969) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 217254) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2021-10-14 |