| NPI | 1659545713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME109892) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: UT 6894390-1205) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2012-04-25 |