| NPI | 1710053681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CO DR-47898) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 219846) |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2015-02-27 |