| NPI | 1912433632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A199919) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OR MD209939) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2025-01-06 |