| NPI | 1801093778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MN 53944) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2007012262) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2020-08-18 |