| NPI | 1457430399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: CA HG26098) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: CO DR.0068157) |
| 2471R0002X Radiologic Technologist Radiation Therapy (Licence: CO DR.0068157) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2024-05-02 |