| NPI | 1801855259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 33538) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: SC 14252) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2012-11-14 |