| NPI | 1982793808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: CA G34598) |
| Additional Taxonomies | 2085R0203X Radiology Therapeutic Radiology (Licence: CA G34598) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2021-10-21 |