| NPI | 1275561011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MD 0067572) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MS 15885) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2014-06-18 |