| NPI | 1881651941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: RI MD09677) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA MA60144) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2011-05-06 |