| NPI | 1235234279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IA 36483) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: SD 5820) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2009-11-17 |