| NPI | 1093809634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A99744) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L1929) |
| 2085R0001X Radiology, Radiation Oncology (Licence: TX L1929) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: TX L1929) | |
| 207R00000X Internal Medicine (Licence: CA A99744) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: CA A99744) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2012-06-25 |