| NPI | 1538266234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: DC MD16513) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: AZ 30912) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2023-03-14 |