| NPI | 1801981311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A22672) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: CA A22672) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2014-07-02 |