| NPI | 1871537894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: DE C1-0007622) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MD D0062556) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2012-07-18 |