| NPI | 1518981380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME110172) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: AL 00018879) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2024-01-03 |