| NPI | 1386874857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME120000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301094360) |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2016-08-16 |