| NPI | 1942306063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MT 7435) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: KY 25955) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2019-10-25 |