| NPI | 1285829036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA C146703) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 251621) |
| 2085R0001X Radiology, Radiation Oncology (Licence: WA ML 60034317) | |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2018-01-26 |