| NPI | 1194815134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A102126) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA NA) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-12-15 |