| NPI | 1083656771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MA 38122) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD027906E) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2015-08-24 |