| NPI | 1487910774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A148496) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CO TL.0004795) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2023-11-27 |