| NPI | 1457589608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: SC 82190) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME124289) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2022-09-06 |