| NPI | 1467403121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD446653) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WI 48025) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2015-09-10 |