| NPI | 1275629578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD435902) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2001-00595) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2022-09-21 |