| NPI | 1447543582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CO 0056393) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX BP10040627) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2021-06-04 |