| NPI | 1093977621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2015-02227) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT192993) |
| 2085R0001X Radiology, Radiation Oncology (Licence: PA MD441200) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: MA 254795) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2019-06-06 |