| NPI | 1568554871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: LA 04300R) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: LA 04300R) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2009-12-21 |