| NPI | 1548722879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: KS 94-09903) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2024031737) |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2024-09-11 |