| NPI | 1447243555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AL MD.7217) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME0013471) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2020-12-16 |