| NPI | 1801986641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA C30500) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: CA C30500) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-09 |