| NPI | 1891726451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AL 00027449) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: GA 61801) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2024-11-05 |