| NPI | 1659318129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: DE C1-0005595) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: MD D0054595) |
| 2085R0001X Radiology Radiation Oncology (Licence: PA MD052967L) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2013-01-02 |