| NPI | 1821053653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: RI MD09674) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 00-59408) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2024-04-19 |