| NPI | 1811994999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: FL ME26427) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NV 4877) |
| 2085R0001X Radiology, Radiation Oncology (Licence: CA G26661) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: FL ME0026427) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: NC 2001-01567) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: NY 127667-1) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2021-07-15 |