| NPI | 1235152232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA G88442) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD-055463-L) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2024-03-18 |