| NPI | 1407839103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME55000) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NV 9241) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2014-08-06 |