| NPI | 1093878787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: GA 72724) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WI 51100-20) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2019-07-17 |