| NPI | 1982961520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD468397) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A150199) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2022-11-14 |