| NPI | 1629158340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA G51488) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: CA G51488) |
| 207R00000X Internal Medicine (Licence: CA G51488) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-07-09 |