| NPI | 1346402682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MA 246073) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2012-05-18 |