| NPI | 1578525531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA 54268) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WI 46415) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2024-02-19 |