| NPI | 1194167189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MN 57009) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MN 106747) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2013-09-13 |