| NPI | 1861495996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD042189E) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MD D0043535) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2020-11-09 |