| NPI | 1689179566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: ME MD26622) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NH 25443) |
| Enumeration Date | 2018-03-24 |
| Last Update Date | 2024-03-28 |