| NPI | 1780740571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TN MD46126) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MT186171) |
| 2085R0001X Radiology, Radiation Oncology (Licence: PA MD435047) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2022-03-24 |