| NPI | 1962898759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NV 21380) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: HI MD-23155) |
| 2085R0001X Radiology, Radiation Oncology (Licence: CA 174309) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: MO 2020009909) | |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2023-09-08 |