| NPI | 1477601235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TN 24590) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: TN 28279) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2024-06-17 |