| NPI | 1225347636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TN 53063) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.058645) |
| Enumeration Date | 2010-10-03 |
| Last Update Date | 2022-03-29 |