| NPI | 1265549422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301058146) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301058146) |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: MI 4301058146) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2013-02-06 |