| NPI | 1770557498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: MA 151945) |
| Additional Taxonomies | 2085R0203X Radiology Therapeutic Radiology (Licence: MA 151945) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2012-08-03 |