| NPI | 1750361259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: CO 26111) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: ID MC-0086) |
| 2085R0001X Radiology Radiation Oncology (Licence: NV 14214) | |
| 2085R0001X Radiology Radiation Oncology (Licence: NM MD2014-0165) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2024-11-19 |