| NPI | 1295945939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101251527) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD432095) |
| 2085R0001X Radiology, Radiation Oncology (Licence: PA MT184390) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2023-08-11 |