| NPI | 1679517932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: DE C10006474) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: MD D0058737) |
| 2085R0001X Radiology Radiation Oncology (Licence: PA MD022600E) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2015-02-13 |