| NPI | 1740386358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME100434) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MD D64773) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2015-04-16 |