| NPI | 1801982939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NE 27361) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OK 26077) |
| 2085R0001X Radiology, Radiation Oncology (Licence: ND 12230) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: WA 35899) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2014-09-03 |