| NPI | 1255696696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME133523) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IL DEA#C7875/AU3890402) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2020-11-04 |