| NPI | 1336168822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NH 12304) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 216655) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2007-07-08 |