| NPI | 1861422420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TN 66747) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX M7333) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2023-05-10 |