| NPI | 1275511149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MA 227432) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 224053) |
| Enumeration Date | 2006-01-02 |
| Last Update Date | 2016-10-06 |