| NPI | 1710478698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MT 118264) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT215090) |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2024-04-08 |