NPI | 1447248463 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MN 76479) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L2310) |
2085R0001X Radiology, Radiation Oncology (Licence: CA C55553) | |
Enumeration Date | 2005-10-13 |
Last Update Date | 2024-08-20 |