| NPI | 1386091148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IA MD-48641) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 218309) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2021-08-05 |