| NPI | 1174083208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: ME MD28085) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NH 32004) |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2024-07-02 |