| NPI | 1801152160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD61349342) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MT MED-PHYS-LIC-56266) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2023-10-25 |