| NPI | 1003832585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301058493) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MI 058493) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2013-12-26 |