| NPI | 1447694922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: ID M-14311) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WY 11797A) |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2021-02-17 |