| NPI | 1538121934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX E8906) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX E8906) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2012-11-19 |