| NPI | 1033185442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: SC 86388) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: GA 89352) |
| 2085R0001X Radiology Radiation Oncology (Licence: CA A54883) | |
| 2085R0001X Radiology Radiation Oncology (Licence: FL ME138035) | |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2022-10-05 |