| NPI | 1033151287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TX E2169) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: TX E2169) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2008-04-25 |