| NPI | 1952572604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: VA 0101242910) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101242910) |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2021-02-25 |