| NPI | 1891745352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NC 19395) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 19395) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-04-27 |