| NPI | 1114945847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: ND 7585) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MN 33963) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2012-01-05 |