| NPI | 1548426018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA 107426) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD60011984) |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2011-05-11 |