| NPI | 1275789026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: UT 8275838-1204) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA OT012054) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2024-07-23 |