| NPI | 1881950012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX Q8712) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10043086) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2021-08-24 |