| NPI | 1922104157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TN 54668) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MS 24846) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2021-06-21 |