| NPI | 1114102407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: SC 89973) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD423422) |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2023-09-07 |