| NPI | 1205008349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: FL ME112340) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: TN 49423) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2022-05-31 |