| NPI | 1528096591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 39233) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: SC 30738) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2021-03-30 |