| NPI | 1407834112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WI 44633) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: ND 5883) |
| 2085R0001X Radiology, Radiation Oncology (Licence: MN 32200) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2024-11-19 |