| NPI | 1568427144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: SD 5511) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NE 23388) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2012-04-13 |