| NPI | 1932209855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: KY C0794) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MN 55943) |
| 2085R0001X Radiology, Radiation Oncology (Licence: FL ME101740) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: CA G50270) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.122946) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2022-08-31 |