| NPI | 1568794030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: GA 055864) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD429033) |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2014-05-05 |