| NPI | 1073597233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: FL ME123173) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A83880) |
| 2085R0001X Radiology Radiation Oncology (Licence: CA A83880) | |
| 2085R0203X Radiology Therapeutic Radiology (Licence: CA A83880) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2015-07-14 |