| NPI | 1649362641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX E3886) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX E3886) |
| 2085R0001X Radiology, Radiation Oncology (Licence: TX E3886) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2013-11-19 |