| NPI | 1982830782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2013-01634) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NC TRN) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2021-06-28 |