| NPI | 1770741928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MT 12726) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: GA 69681) |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2013-05-01 |