| NPI | 1780665760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA G89069) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MN 30747) |
| 2085R0001X Radiology, Radiation Oncology (Licence: NC 99-00211) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: NC 99-00211) | |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2012-09-11 |