| NPI | 1851463756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2009010338) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101240320) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2022-10-05 |