| NPI | 1568880060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A163217) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX BP10052299) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2023-11-27 |