| NPI | 1689808149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX N4377) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX bp20029203) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2023-04-24 |