| NPI | 1427255314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AZ 48773) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 81951) |
| 2085R0001X Radiology, Radiation Oncology (Licence: TX P3430) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2014-04-30 |