| NPI | 1043407992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A102378) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IL Pending) |
| 2085R0001X Radiology, Radiation Oncology (Licence: WA MD60327415) | |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2015-08-11 |