NPI | 1235161548 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q4418) |
Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: PA MD059654L) |
2085R0001X Radiology, Radiation Oncology (Licence: PA MD059654L) | |
Enumeration Date | 2006-07-07 |
Last Update Date | 2015-10-26 |