| NPI | 1871121095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: MD D0103630) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: KY R5549) |
| 2085R0001X Radiology Radiation Oncology (Licence: DC MD600004447) | |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2025-07-01 |