| NPI | 1194781377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME102789) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 205132) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2016-11-09 |