| NPI | 1053306266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: KS 04-38634) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WV 29220) |
| 2085R0001X Radiology, Radiation Oncology (Licence: GA 060442) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: TN 040060) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: NY 236157) | |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2020-01-29 |