| NPI | 1013337054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MN 59738) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MN 108509) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2020-08-18 |