NPI | 1790932630 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MT194731) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-055026) |
Enumeration Date | 2008-08-21 |
Last Update Date | 2013-09-20 |