| NPI | 1982675021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA G49856) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MS 18643) |
| 2085R0001X Radiology, Radiation Oncology (Licence: AZ AZ47460) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: WA MD 00031750) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: AZ 47460) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2014-07-10 |