| NPI | 1336338912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: MO R7D72) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2007-10-18 |