| NPI | 1396181731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MN 58506) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MN 107740) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2018-08-21 |