| NPI | 1548463367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME147469) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A118381) |
| 2085R0001X Radiology, Radiation Oncology (Licence: PA MT187868) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2022-08-16 |