| NPI | 1942331558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX J0924) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: AK AK 5038) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2012-10-03 |