| NPI | 1194788331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: KS 04-31206) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2005010985) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2023-06-09 |