| NPI | 1679869283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OR MD185967) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OK 32248) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2023-08-07 |