| NPI | 1346223799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: LA MD.05613) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: GA 053474) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2010-09-21 |