| NPI | 1831410729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: PA MD455429) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT198214) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2015-09-24 |