| NPI | 1861804148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NV 18820) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: UT 9538369-1205) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2024-02-29 |