| NPI | 1639663735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A164978) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.071815) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2023-09-05 |