| NPI | 1043416548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IA 39980) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R8061) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2012-05-17 |