| NPI | 1801834767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 200701598) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2023048760) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2024-04-05 |