| NPI | 1972788479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: SC 34362) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A104480) |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2021-06-14 |