| NPI | 1477788263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2010-01742) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101276736) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2023-05-22 |