| NPI | 1750503132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OR MD186371) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD00047718) |
| 2085R0001X Radiology, Radiation Oncology (Licence: CA A86003) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-09-28 |