| NPI | 1154492817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME107502) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 227673) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2022-03-09 |