| NPI | 1609873785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: SC TL33194) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: FL ME0077442) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2024-04-19 |