| NPI | 1053540146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology Therapeutic Radiology (Licence: GA 0651056) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 003712) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2015-10-16 |