| NPI | 1720075088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AZ AZ22917) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: AZ 22917) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2016-09-21 |