| NPI | 1518166081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NM MD20120262) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301090487) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2023-11-29 |