| NPI | 1699799981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: UT 187816-1205) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WY 12470A) |
| 2085R0001X Radiology, Radiation Oncology (Licence: MT 10960) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2024-11-12 |