| NPI | 1548251010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: GA 045840) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME 81043) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2022-02-10 |