| NPI | 1275910812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MN 66859) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME129176) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2020-08-21 |