| NPI | 1033255138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MD D70510) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MD V0120) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2013-02-07 |