| NPI | 1609049873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: MN 72883) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: PA MD471380) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2022-11-28 |