| NPI | 1770698169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: KY 36408) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01053637A) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-07-08 |