| NPI | 1154416923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX N3349) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MO BB4745785-2004014122) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2010-02-19 |