| NPI | 1508813817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OR DO26902) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: CO 28947) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2021-11-29 |