| NPI | 1356431688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: FL ME100900) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: FL TRN7768) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2011-12-13 |