| NPI | 1235152182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD-023277-E) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD-023277-E) |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: PA MD-023277-E) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2011-11-17 |