| NPI | 1437154630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2000158663) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 2000158663) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2013-02-12 |