| NPI | 1316921281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MS 20845) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME93556) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2013-09-04 |