| NPI | 1356333959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: ID M5308) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD00020143) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2017-03-24 |