| NPI | 1780657510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CT 21529) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 021529) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2019-10-21 |