| NPI | 1851654172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NE 1073) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA OS019478) |
| 208D00000X General Practice (Licence: NE 1073) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2024-04-11 |