| NPI | 1528528965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MT218487) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD.MD.61524725) |
| 2085R0001X Radiology, Radiation Oncology (Licence: PA MD479731) | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2024-04-23 |