| NPI | 1477763365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX P3651) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MS 20482) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2023-07-10 |