| NPI | 1285869362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TN 51603) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MS 23666) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2016-04-05 |