| NPI | 1346240306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: SC 14002) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: SC 200400438) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2010-05-05 |