| NPI | 1730381658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME117706) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WV 24576) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2020-10-07 |