| NPI | 1205829058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IA 33213) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 33213) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2007-11-28 |