| NPI | 1730293887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MS 15814) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: ND 20313) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2023-12-28 |