| NPI | 1427581560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: ME MD25306) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: UT 10957219-1205) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2023-01-25 |