| NPI | 1568955045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD479202) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT215436) |
| 2085R0001X Radiology, Radiation Oncology (Licence: PA MT215436) | |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2023-10-20 |