| NPI | 1740642081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX T1486) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2085R0001X Radiology, Radiation Oncology | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2022-07-21 |