| NPI | 1942525423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A114416) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WA BC60500955) |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2021-08-04 |