| NPI | 1689832081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IA 41041) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-8366) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2013-06-10 |