| NPI | 1285072918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A156335) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 256500) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2018-08-03 |