| NPI | 1437507274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: VA 0101271548) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 267575) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2021-07-14 |