| NPI | 1710979687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA G22896) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301115702) |
| 2085R0001X Radiology, Radiation Oncology (Licence: IN 01081578A) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: MI 4301115702) | |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2023-01-17 |