| NPI | 1154434264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: GA 054147) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TN MD36908) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2018-04-03 |