NPI | 1497405104 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME165189) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN35466) |
Enumeration Date | 2022-03-25 |
Last Update Date | 2023-12-11 |