| NPI | 1659469476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: SC 90982) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: KY TP188) |
| 2085R0001X Radiology, Radiation Oncology (Licence: KY 43878) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2023-11-29 |