| NPI | 1033118005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: SC 13735) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME0062123) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2007-10-10 |