| NPI | 1568422723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: AZ 58024) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: TX M7949) |
| 2085R0001X Radiology Radiation Oncology (Licence: IL 036-112662) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2023-06-20 |