| NPI | 1467435800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2012-00595) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA OS007421E) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2016-05-02 |