| NPI | 1184982639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: GA 000000) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME119372) |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2017-05-03 |