NPI | 1609131523 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME127765) |
Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MI 261Q00000X) |
Enumeration Date | 2012-07-06 |
Last Update Date | 2016-07-21 |