| NPI | 1841269297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301116479) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WI 84362) |
| 2085R0001X Radiology, Radiation Oncology (Licence: AZ 46353) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2025-02-19 |