| NPI | 1235357294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: ME MD17399) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NH 25134) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2025-04-07 |