| NPI | 1376778258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2014013923) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: GA 079384) |
| 2085R0001X Radiology, Radiation Oncology (Licence: KS 04-37203) | |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2020-10-27 |