| NPI | 1144268590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME51772) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX K3067) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2016-10-20 |