| NPI | 1154397891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2009019828) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WI 44597) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2013-10-01 |