| NPI | 1164422523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD-045641-L) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MD D0060531) |
| 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101046483) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: DE C1-0007087) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: KY 36651) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2018-06-06 |