| NPI | 1720433766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AZ 62956) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 218421) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2021-07-03 |