| NPI | 1659767127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX BP20058072) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX R8918) |
| Enumeration Date | 2015-04-11 |
| Last Update Date | 2024-12-12 |