| NPI | 1396769204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME121452) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: GA 052353) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2025-03-12 |