| NPI | 1790990356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NH 14839) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 242794) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2010-08-09 |