| NPI | 1487641700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: KY 40518) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NC 01042349A) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2022-12-12 |