| NPI | 1255318432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MN 35850) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MN 358950) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2024-09-24 |