| NPI | 1841382660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: RI MD12575) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2006-01262) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2022-01-05 |