| NPI | 1134485618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2017017637) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: KS 04-39983) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2021-09-24 |