| NPI | 1205891603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NV 8735) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A43780) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2017-03-02 |