| NPI | 1487097572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MN 76210) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2018017681) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2024-04-03 |