| NPI | 1134180656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: GA 29468) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: FL ME54316) |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2015-11-05 |