| NPI | 1033229380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME112967) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: GA 056109) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-12-21 |