| NPI | 1932548484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WI 4275) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA not yet received) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2024-08-20 |