| NPI | 1831301381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NE 24867) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A91182) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2023-01-16 |