| NPI | 1558395244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA G71943) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: CA G71943) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-01-23 |