| NPI | 1407170277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME123214) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL TRN16450) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2023-06-21 |