| NPI | 1508827247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2018-02325) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD 042004-L) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2019-05-24 |