| NPI | 1326060773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: GA 60444) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD-029941-E) |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: GA 060444) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2023-12-28 |