| NPI | 1972604510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: ID M9933) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MT 9984) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-09-19 |