| NPI | 1831128164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101038926) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101038926) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2008-01-23 |