| NPI | 1740346543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: LA MD.201591) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MT182043) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2017-04-06 |