| NPI | 1598919243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME 116959) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A103983) |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2023-04-19 |