| NPI | 1528527645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: RI MD19668) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 284661) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2024-06-14 |