| NPI | 1467402172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301106591) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: WI 47459) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2020-10-22 |