| NPI | 1568552859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: CA G48958) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G48958) |
| Enumeration Date | 2006-10-15 |
| Last Update Date | 2009-08-26 |