| NPI | 1649597378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MN 64598) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301097967) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2020-08-20 |