| NPI | 1275640260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: GA 079037) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX K7280) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2018-03-17 |