| NPI | 1700845625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101237913) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NC 200500321) |
| 2085R0001X Radiology, Radiation Oncology (Licence: SC 27648) | |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2016-04-26 |