| NPI | 1215228614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: GA 90312) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: ME MD21198) |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2025-01-10 |