| NPI | 1942231410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: VA 010128097) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: VA 010128097) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2007-07-09 |