| NPI | 1811132152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A99154) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: LA MD204057) |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2023-07-19 |