| NPI | 1215038344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 251104-1) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX L6319) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2012-08-08 |