| NPI | 1164641791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: IL 036-125259) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: MI 4301086154) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2011-02-24 |