| NPI | 1609808864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX M4444) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A80413) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2010-09-15 |