| NPI | 1699333252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: GA 100556) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4351045087) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2024-06-18 |