| NPI | 1134207574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301093584) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WI 49845) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2013-11-04 |