| NPI | 1407176084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MA 253571) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 244781) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2015-09-08 |