| NPI | 1770597353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AL 19334) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OK 29754) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-01-31 |