| NPI | 1669595518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: FL ME114744) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: AL MD.31976) |
| Enumeration Date | 2007-04-07 |
| Last Update Date | 2022-07-20 |