| NPI | 1396768255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: DE C1-0023946) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD057907L) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-10-27 |