| NPI | 1447440961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: KY 61046) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: CA AFE105634) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2025-07-01 |