| NPI | 1538142591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NV 18784) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX l9634) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2019-05-24 |