| NPI | 1871906396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: CA A160913) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A160913) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2019-07-10 |