| NPI | 1881682573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OR MD22525) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD00028858) |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: OR MD22525) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: WA MD00028858) | |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2014-09-12 |