| NPI | 1710093166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AR E-8136) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 78272) |
| 2085R0001X Radiology, Radiation Oncology (Licence: OK 25750) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2024-02-28 |