| NPI | 1710052212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD440489) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL trn9921) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2018-04-13 |