| NPI | 1568444529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: SC DO949) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA 05011096L) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2024-04-19 |