| NPI | 1285154237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301506483) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301112058) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2022-06-22 |