| NPI | 1326130725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301059592) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME111595) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2013-12-12 |