| NPI | 1437442472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: LA 302385) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX BP10040623) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2016-12-08 |