| NPI | 1265669980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WI 57317) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MN 105028) |
| 2085R0001X Radiology, Radiation Oncology (Licence: MN 53516) | |
| 207R00000X Internal Medicine (Licence: NM RS2009-0303) | |
| Enumeration Date | 2009-06-20 |
| Last Update Date | 2024-06-28 |