| NPI | 1891720165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: RI MD14595) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 216597) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2014-09-23 |