| NPI | 1538103551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: DE C1-0006137) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MD D0057797) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2012-08-30 |