| NPI | 1952385551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: AL 00006670) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: FL ME22622) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2022-07-21 |