| NPI | 1306045752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2011-01884) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: SC MMD-34414-TL) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2013-04-10 |