| NPI | 1568433373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD438043) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX K0873) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2011-11-28 |