| NPI | 1518999564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME54431) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A43279) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2022-07-21 |