| NPI | 1902894793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD00036294) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OR MD23372) |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: OR MD23372) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: WA MD00036294) | |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2007-12-01 |