| NPI | 1093070054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: UT 8781019-8905) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 34749) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2017-03-27 |