| NPI | 1578565420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IL 036117479) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35081855) |
| 2085R0001X Radiology, Radiation Oncology (Licence: NV 13493) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: FL ME114482) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2015-10-19 |