| NPI | 1730747791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A182501) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 280429) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2024-08-15 |