| NPI | 1598803512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX R4864) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA G84199) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2018-07-30 |