| NPI | 1003068347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX Q3235) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WI 60431) |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2015-11-13 |