| NPI | 1386931764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: GA 077882) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: FL ME120828) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2024-12-27 |