| NPI | 1952307522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OR MD28266) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A75314) |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2009-06-25 |