| NPI | 1285868968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: ND 14404) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: SC MMD.32576LL) |
| 2085R0001X Radiology, Radiation Oncology (Licence: MO 2014034663) | |
| 207R00000X Internal Medicine (Licence: TX BP10034767) | |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2024-04-04 |