| NPI | 1922060722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MS MS19362) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX J1203) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2013-10-17 |