| NPI | 1124330311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2018-01135) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2018-01135) |
| 2085R0001X Radiology, Radiation Oncology (Licence: OK 32438) | |
| Enumeration Date | 2010-07-05 |
| Last Update Date | 2021-03-25 |