| NPI | 1063947653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: KS 04-46823) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 665483) |
| 2085R0001X Radiology, Radiation Oncology (Licence: MO 2022041017) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: CO TL.0007450) | |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2024-08-25 |