| NPI | 1619094513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: FL ME152311) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: IL 036140165) |
| 2085R0001X Radiology Radiation Oncology (Licence: MO 2008006963) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2023-09-29 |