| NPI | 1578571394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: ME MD13308) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NH 24920) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2024-03-28 |