| NPI | 1699054874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301501781) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125059272) |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2020-05-13 |