| NPI | 1043233810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MS 18104) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A60276) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-07-08 |