| NPI | 1871565556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AK 6548) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TN MD0000036692) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2010-08-12 |