| NPI | 1770922353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: GA 080369) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL35935) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2018-07-18 |