| NPI | 1447243670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NC 2023-00903) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: FL ME89864) |
| 2085R0001X Radiology Radiation Oncology (Licence: TN 47377) | |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2023-06-19 |