| NPI | 1689675902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX K2566) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A73839) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2023-10-13 |