| NPI | 1861830234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: GA 081211) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 255415) |
| 2085R0001X Radiology, Radiation Oncology (Licence: CA A155063) | |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2018-08-15 |