| NPI | 1700824794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MD D0063835) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: DE C1-0007945) |
| 2085R0001X Radiology, Radiation Oncology (Licence: PA MD445025) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2024-08-05 |