| NPI | 1396808010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: GA 065988) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT189287) |
| 2085R0001X Radiology, Radiation Oncology (Licence: PA MD435649) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: GA 65988) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2013-10-31 |