| NPI | 1619114592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CO 52282) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A90774) |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2021-06-04 |