| NPI | 1285600403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA C54574) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI md-13697) |
| 208D00000X General Practice (Licence: CA C54574) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2015-02-03 |