| NPI | 1831188036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD00044645) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: ID M-12234) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2017-03-24 |