| NPI | 1821289893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2016036874) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OK 25819) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2016-11-16 |