| NPI | 1548222490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME99312) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L7637) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2024-04-23 |