| NPI | 1730332693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX Q6455) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME112837) |
| 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA08542600) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: PA MD432991) | |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2022-01-13 |