| NPI | 1659361582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MN 25415) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME40986) |
| Enumeration Date | 2005-10-22 |
| Last Update Date | 2024-07-05 |