| NPI | 1912226267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME169665) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: AL 33142) |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2024-11-19 |