| NPI | 1851670293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD463840) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME112555) |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2023-03-23 |