| NPI | 1073505244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD445161) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA G49070) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2012-08-14 |