| NPI | 1184654253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MD D72602) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD419246) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2013-02-15 |