| NPI | 1578675112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD453550) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA05439800) |
| 2085R0001X Radiology, Radiation Oncology (Licence: NY 273085-01) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: GA 77394) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: TN MD0000052236) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.141290) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: OH 35141290) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2021-05-13 |