| NPI | 1598259061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD480735) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301115206) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2023-06-23 |