| NPI | 1992729230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: ND 11822) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MN 48922) |
| 2085R0001X Radiology, Radiation Oncology (Licence: OR MD125825) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: WI 51933-020) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2011-11-18 |