| NPI | 1407011208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AK 8330) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MT193247) |
| 2085R0001X Radiology, Radiation Oncology (Licence: FL ME112529) | |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2014-09-03 |