| NPI | 1508325861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: ND 20929) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 11037) |
| Enumeration Date | 2019-03-17 |
| Last Update Date | 2024-07-11 |