| NPI | 1275532095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX Q9990) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME87489) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2017-04-10 |