| NPI | 1295092351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME160039) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MD D83473) |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2023-01-31 |