| NPI | 1811315286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX S1460) |
| Additional Taxonomies | 261QX0203X Clinic/Center, Oncology, Radiation |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2024-07-03 |