| NPI | 1659363067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: LA 308265) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: SC 11773) |
| 2085R0001X Radiology, Radiation Oncology (Licence: AL 9773) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: MS 15829) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: TN 47775) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2024-02-06 |