| NPI | 1124219241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME148357) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WI 51615) |
| 2085R0001X Radiology, Radiation Oncology (Licence: IL 036121114) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2021-04-13 |