| NPI | 1811933047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MA 246019) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CO 44895) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2020-04-22 |