| NPI | 1720053705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IA 37665) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA G083479) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2008-12-12 |