| NPI | 1669538443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA C1171699) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: GA 081672) |
| 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101243108) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: PA MD425082) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: PA MT181847) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2021-05-28 |