| NPI | 1043579410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2017014181) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: KS 04-39979) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2022-07-21 |