| NPI | 1033328703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101242596) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0101242596) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2019-03-26 |