| NPI | 1770561433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: MT 49277) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: PA MD418114) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2022-10-20 |