| NPI | 1013935477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD422682) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 245215) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2013-06-17 |