| NPI | 1174973739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: CA A151481) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 268074) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2021-05-25 |