| NPI | 1457323693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology Therapeutic Radiology (Licence: ID M-11219) |
| Additional Taxonomies | 2085R0203X Radiology Therapeutic Radiology (Licence: NC 2009-00298) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2013-04-25 |