| NPI | 1952309569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA C43111) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G49966) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2015-06-01 |