| NPI | 1699841254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NV 12398) |
| Additional Taxonomies | 174400000X Specialist (Licence: HI MD10713) |
| 2085R0001X Radiology, Radiation Oncology (Licence: KY 45674) | |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2020-09-10 |