| NPI | 1750693453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2011-01825) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA G84452) |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2011-12-20 |