| NPI | 1578940045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A143827) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 209574) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2020-07-21 |