| NPI | 1003878182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A44135) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A44135) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2007-09-12 |