| NPI | 1326480245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WI 68600-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125063200) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2018-07-12 |