| NPI | 1033108139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX M3299) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OK 24343) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2014-12-29 |