| NPI | 1225126535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MD D51922) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: MD D51922) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2019-03-18 |