| NPI | 1962842781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NV 20030) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: HI MD-22685) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2022-11-12 |