| NPI | 1023471679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: GA 88561) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 218342) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2021-04-28 |