| NPI | 1629022553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA C129435) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: AZ 30940) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2023-04-04 |