| NPI | 1669546164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A87508) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX R4265) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2022-01-21 |