| NPI | 1386164507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OK 39055) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 8009) |
| 2085R0001X Radiology, Radiation Oncology (Licence: TX BP10065479) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2022-04-18 |