| NPI | 1720018682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MD D0051022) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: DC MD30213) |
| 2085R0001X Radiology, Radiation Oncology (Licence: DE C1-0004342) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101050198) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2012-04-18 |