| NPI | 1316358492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: KS 05-42139) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX U5711) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2023-08-31 |