| NPI | 1265409072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: GA 062077) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WI 34367) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2009-04-06 |