| NPI | 1578723532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD443988) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MT193224) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2022-08-19 |