| NPI | 1750441770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AZ 37997) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MN 46352) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2022-03-16 |