| NPI | 1063474245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MN 41035) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MN 103927) |
| 2085R0001X Radiology, Radiation Oncology (Licence: FL ME95432) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2020-08-19 |