| NPI | 1699726349 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MT 11419) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WY 6725A) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2017-02-15 |