| NPI | 1851457618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD429766) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MT183952) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2012-09-25 |