| NPI | 1033357991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX P6422) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A110308) |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2014-08-15 |