| NPI | 1417367863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TN 62986) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME127684) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2021-12-21 |