| NPI | 1720059181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IA MD-49706) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD00034810) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2024-11-08 |