| NPI | 1952831984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: UT 14008010-1205) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TN 58217) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2024-06-18 |