| NPI | 1568570497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: KY 20283) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: IN 01033494A) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-07-08 |