| NPI | 1962686238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: GA 62803) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 002626) |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2018-12-07 |