| NPI | 1780724427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA G11302) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: CA G11302) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2007-07-08 |