| NPI | 1932335957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME119688) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN13991) |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2022-04-29 |