| NPI | 1942264023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: TN 21007) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: AR E1211) |
| 2085R0001X Radiology Radiation Oncology (Licence: MS 23794) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2016-02-24 |