| NPI | 1265471338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD479412) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: PA MD479412) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA G59973) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2024-05-22 |