| NPI | 1942864541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WI 77651-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R77951) |
| 2085R0001X Radiology, Radiation Oncology (Licence: WI 9031-851) | |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2022-11-10 |