| NPI | 1871663401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: TX F2418) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: CA G29884) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2024-06-13 |