| NPI | 1508854290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: ID M-14114) |
| Additional Taxonomies | 2085R0203X Radiology Therapeutic Radiology (Licence: OR MD09427) |
| 2085R0001X Radiology Radiation Oncology (Licence: OR MD09427) | |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2022-09-28 |