| NPI | 1871552950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA C130278) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101236519) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2014-09-15 |