| NPI | 1205137585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD462695) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA mt196821) |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2021-01-23 |