| NPI | 1376522300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME77301) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: AL 00022738) |
| 2085R0001X Radiology, Radiation Oncology (Licence: CA g73658) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2018-04-19 |