| NPI | 1649811167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MN 74852) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IL 125.078925) |
| 207R00000X Internal Medicine (Licence: IL 125.078925) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: MN 33834) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: MN 30212) | |
| Enumeration Date | 2019-10-06 |
| Last Update Date | 2023-07-24 |