NPI | 1851824650 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX T4272) |
Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301510476) |
Enumeration Date | 2017-04-07 |
Last Update Date | 2024-09-16 |