| NPI | 1225006463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME116765) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: LA 201833) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2023-02-27 |