| NPI | 1598789570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: TX M2924) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: NM MD2018-0864) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-05-19 |