| NPI | 1942363304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CT 69326) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT188594) |
| 2085R0001X Radiology, Radiation Oncology (Licence: NY 261756) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: PA md436165) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2021-08-24 |