| NPI | 1639311632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: LA 337940) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: VA 0101255612) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2023-08-27 |